| NPI | 1265732556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 7921151-3902) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 7921151-6004) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2024-04-23 |