| NPI | 1255572632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65340) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 10826) |
| 101YM0800X Counselor, Mental Health (Licence: TX 65340) | |
| 101YP1600X Counselor, Pastoral | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2022-02-25 |