NPI | 1154829042 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2018-01-25 |
Last Update Date | 2018-01-25 |