NPI | 1114143054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: TX 31528) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling |
Enumeration Date | 2007-04-18 |
Last Update Date | 2025-08-11 |