| NPI | 1134299696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 000661034102) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 10554) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-11-22 |