| NPI | 1073534699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: TN 18) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TN 275) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-07-21 |