NPI | 1366677668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TN 748) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN 2426) |
Enumeration Date | 2009-05-15 |
Last Update Date | 2021-04-21 |