| NPI | 1093734303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 68943) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL MH8209) |
| 101YP2500X Counselor, Professional (Licence: LA LPC 2001) | |
| 106H00000X Marriage & Family Therapist (Licence: LA LMFT 610) | |
| 101YP2500X Counselor, Professional (Licence: CO 6341) | |
| 101YP2500X Counselor, Professional (Licence: NM 144781) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-03-16 |