NPI | 1225214828 |
---|---|
Other Name | THE WANDERING THERAPIST |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 7997802-3902) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: ID MFTI-3914) |
Enumeration Date | 2008-01-14 |
Last Update Date | 2020-05-05 |