NPI | 1215029178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LA 99) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 1734) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2011-06-20 |