NPI | 1326095530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 3243) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 1420-042363) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2007-07-08 |