| NPI | 1225487440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MG61683560) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 205410) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2025-05-15 |