| NPI | 1245884386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 4527-R) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health (Licence: NV CP5395-R) | |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| 106H00000X Marriage & Family Therapist (Licence: CA 138517) | |
| Enumeration Date | 2019-07-26 |
| Last Update Date | 2023-06-21 |