NPI | 1881947216 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YP2500X Counselor, Professional | |
102L00000X Psychoanalyst | |
Enumeration Date | 2012-10-23 |
Last Update Date | 2012-10-23 |