NPI | 1285774927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 10173) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 2065) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2007-07-08 |