NPI | 1366591513 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: TX 10956) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 3407) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2007-07-08 |