| NPI | 1356580146 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX LCSW00383) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX LPC00791) | 
| 101YM0800X Counselor, Mental Health (Licence: TX LCSW0383) | |
| 101YP2500X Counselor, Professional (Licence: TX LPC00791) | |
| 106H00000X Marriage & Family Therapist (Licence: TX LMFT00561) | |
| 102L00000X Psychoanalyst (Licence: TX LCSW0383) | |
| 104100000X Social Worker (Licence: TX LCSW0383) | |
| 103K00000X Behavior Analyst (Licence: TX LCSW0383) | |
| 101YM0800X Counselor, Mental Health (Licence: TX LCSW00791) | |
| 106H00000X Marriage & Family Therapist (Licence: TX LPC00791) | |
| Enumeration Date | 2009-02-18 | 
| Last Update Date | 2009-07-21 |