NPI | 1922234525 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: CA 29025) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA 29025) |
103TC0700X Psychologist, Clinical (Licence: CA 29025) | |
103TC1900X Psychologist, Counseling (Licence: CA 29025) | |
103TH0100X Psychologist, Health Service (Licence: CA 29025) | |
103TP2701X Psychologist, Group Psychotherapy (Licence: CA 29025) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-06-09 |
Last Update Date | 2023-02-15 |