| NPI | 1346724010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 203148) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2025-06-17 |