| NPI | 1063765246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 14527) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: TX 14527) |
| 101YP2500X Counselor, Professional (Licence: TX 14527) | |
| 101YS0200X Counselor, School (Licence: TX 14527) | |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2024-05-02 |