| NPI | 1275470114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 14163735-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA MFT.LF.70127504) |
| Enumeration Date | 2026-04-29 |
| Last Update Date | 2026-08-21 |