| NPI | 1033449269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN LMT0000000770) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN LPC0000002666) |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2014-11-08 |