| NPI | 1245442383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-004382) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF 51638) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |