| NPI | 1053180828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0003028) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 2441) |
| 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0021800) | |
| 106H00000X Marriage & Family Therapist (Licence: OR T3538) | |
| Enumeration Date | 2023-12-21 |
| Last Update Date | 2026-02-26 |