| NPI | 1225205420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KS 2927) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 005547) |
| 106H00000X Marriage & Family Therapist (Licence: LA 880) | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2024-10-14 |