| NPI | 1316190655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2014-02-20 |