NPI | 1316219777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NV MI0691) |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2012-02-01 |
Last Update Date | 2019-01-24 |