| NPI | 1326362435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NV 4139) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NV LADC 1200) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2023-09-04 |