| NPI | 1992897334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN LCSW34003052) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN LMFT35000635) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2023-01-14 |