NPI | 1306852330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL MT 2491) |
Additional Taxonomies | 103K00000X Behavior Analyst |
101Y00000X Counselor | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2019-06-24 |