| NPI | 1366591497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 4828 44622) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2008-08-12 |