| NPI | 1104246206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO LMFT.0002235) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO MFTC.0014028) |
| 103K00000X Behavior Analyst | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2023-05-04 |