| NPI | 1194931246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL 360) |
| 106H00000X Marriage & Family Therapist (Licence: AL 28) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |