| NPI | 1932867389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00835000) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00350800) |
| 101YM0800X Counselor, Mental Health (Licence: NJ 37AC00498100) | |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2024-11-25 |