NPI | 1326410424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 69304) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 202091) |
Enumeration Date | 2015-10-28 |
Last Update Date | 2016-08-29 |