NPI | 1023397270 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN 0000000647) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral |
Enumeration Date | 2011-08-05 |
Last Update Date | 2011-11-20 |