| NPI | 1093867780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: VA AAPC195) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NY 002819-1) |
| 106H00000X Marriage & Family Therapist (Licence: NY 000381-1) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2025-09-11 |