| NPI | 1932331790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NY 003423-1) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 003423-1) |
| 106H00000X Marriage & Family Therapist (Licence: NY 000639-1) | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |