NPI | 1073204301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR R8345) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R8345) |
Enumeration Date | 2023-05-17 |
Last Update Date | 2023-05-17 |