NPI | 1174381396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101Y00000X Counselor | |
102L00000X Psychoanalyst | |
101YP2500X Counselor, Professional | |
Enumeration Date | 2024-03-12 |
Last Update Date | 2025-09-21 |