NPI | 1922075209 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IN 34002601A) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 39000428A) |
106H00000X Marriage & Family Therapist (Licence: IN 35000705A) | |
101Y00000X Counselor (Licence: IN 34002601A) | |
101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IN 34002601A) | |
Enumeration Date | 2006-03-04 |
Last Update Date | 2009-04-29 |