| NPI | 1881841633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DE PC0000423) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC13932) |
| 101YM0800X Counselor, Mental Health (Licence: NJ #3700PC0212900) | |
| 101YM0800X Counselor, Mental Health (Licence: FL #MH3304) | |
| Enumeration Date | 2008-08-23 |
| Last Update Date | 2015-12-31 |