| NPI | 1033621735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP1600X Counselor, Pastoral (Licence: NC TNS794A) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2019-09-20 |