| NPI | 1144438300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 3337) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 2436) |
| 101YP2500X Counselor, Professional (Licence: SC 2384) | |
| 106H00000X Marriage & Family Therapist (Licence: NC 558) | |
| 106H00000X Marriage & Family Therapist (Licence: SC 2513) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2007-07-08 |