NPI | 1023748548 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 2585) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 12425A) |
106H00000X Marriage & Family Therapist (Licence: NC 12425A) | |
Enumeration Date | 2022-06-16 |
Last Update Date | 2023-08-21 |