NPI | 1902855547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7305) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: FL PY7305) |
103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY7305) | |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY7305) | |
103T00000X Psychologist (Licence: FL PY7305) | |
103TC1900X Psychologist, Counseling (Licence: FL PY7305) | |
103TF0000X Psychologist, Family (Licence: FL PY7305) | |
103TH0100X Psychologist, Health Service (Licence: FL PY7305) | |
103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: FL PY7305) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: FL PY7305) | |
103TR0400X Psychologist, Rehabilitation (Licence: FL PY7305) | |
103TH0004X Psychologist, Health (Licence: FL PY7305) | |
Enumeration Date | 2006-05-10 |
Last Update Date | 2011-06-27 |