| NPI | 1356431407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN P0001746) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TN P0001746) |
| 101Y00000X Counselor (Licence: TN P0001746) | |
| 101YM0800X Counselor, Mental Health (Licence: TN P0001746) | |
| 101YP2500X Counselor, Professional (Licence: TN LPC000262) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: TN P0001746) | |
| 103T00000X Psychologist (Licence: TN P0001746) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TN P0001746) | |
| 103TC1900X Psychologist, Counseling (Licence: TN P0001746) | |
| 103TF0000X Psychologist, Family (Licence: TN P0001746) | |
| 103TH0004X Psychologist, Health (Licence: TN P0001746) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-08 |