| NPI | 1033883814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 12807094-3902) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2025-02-12 |