| NPI | 1013376722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: AR P1604051) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AR P1604051) |
| 101YP1600X Counselor Pastoral (Licence: AR P1604051) | |
| 106H00000X Marriage & Family Therapist (Licence: AR M1604004) | |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2022-09-10 |