| NPI | 1093970352 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN LPC000000038) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN LPC000000038) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2008-07-25 |