| NPI | 1346458395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 5220) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 19990) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-09-29 |