| NPI | 1366518532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39000576A) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35001420A) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2007-07-08 |