NPI | 1376911388 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 99041) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
101Y00000X Counselor | |
Enumeration Date | 2015-09-08 |
Last Update Date | 2017-04-01 |