| NPI | 1396472072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: DE FA-0010024) |
| Additional Taxonomies | 101YS0200X Counselor School |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2024-01-26 |