| NPI | 1396084786 |
|---|---|
| Other Name | JOHN S SOUTHERN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 0571) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IL 071009636) |
| 106H00000X Marriage & Family Therapist (Licence: MS T0188) | |
| 101YP2500X Counselor, Professional (Licence: TX 08559) | |
| 103T00000X Psychologist (Licence: PA 003695) | |
| 103T00000X Psychologist (Licence: CA 30540) | |
| 103T00000X Psychologist (Licence: IL 071.009636) | |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2019-04-11 |