NPI | 1033549415 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 1821) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MS T10467A) |
Enumeration Date | 2013-11-20 |
Last Update Date | 2023-06-08 |