| NPI | 1144558941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 460) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: NC 19) |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2009-12-07 |