NPI | 1245321868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL sw146) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL lmft333) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2008-05-29 |