NPI | 1144661729 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 1492) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral |
106H00000X Marriage & Family Therapist (Licence: OK 722) | |
Enumeration Date | 2013-07-11 |
Last Update Date | 2013-07-11 |