NPI | 1235390014 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 201427) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 63922) |
101YM0800X Counselor, Mental Health (Licence: TX 63922) | |
101YP2500X Counselor, Professional (Licence: TX 63922) | |
Enumeration Date | 2008-06-24 |
Last Update Date | 2018-11-19 |