| NPI | 1275701526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 16227) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 16227) |
| 101YM0800X Counselor Mental Health (Licence: TX 16227) | |
| 101YP1600X Counselor Pastoral (Licence: TX 16227) | |
| 101YP2500X Counselor Professional (Licence: TX 16227) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 16227) | |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2008-02-20 |