| NPI | 1134643174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR M2010013) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR F1707005) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2024-03-18 |