| NPI | 1225132400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX LMFT#5210) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX LBSW#S31626) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2018-08-20 |