NPI | 1043270713 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 14790) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2006-03-25 |
Last Update Date | 2007-07-08 |