| NPI | 1275343733 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 92598) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 92598) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 92598) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 92598) | |
| 101YP1600X Counselor, Pastoral (Licence: TX 92598) | |
| 101YS0200X Counselor, School (Licence: TX 92598) | |
| 171000000X Military Health Care Provider | |
| 171400000X Health & Wellness Coach | |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-04-20 |