| NPI | 1174680433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TN LPC0000000575) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TN LPC000000575) |
| 106H00000X Marriage & Family Therapist (Licence: TN LPC0000000575) | |
| 101YM0800X Counselor Mental Health (Licence: TN LPC0000000575) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2023-12-27 |