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 |