| NPI | 1932269974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NJ 37FI00111200) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC0040600) |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00292700) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2025-09-11 |