NPI | 1215292461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN 982) |
Additional Taxonomies | 101Y00000X Counselor |
102L00000X Psychoanalyst | |
Enumeration Date | 2012-07-12 |
Last Update Date | 2018-04-26 |