| NPI | 1053591925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 0677) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 423) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2007-11-08 |