| NPI | 1437403326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 15461) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DE 15461) |
| 101YM0800X Counselor, Mental Health (Licence: FL 15461) | |
| 101YP1600X Counselor, Pastoral (Licence: DE 15461) | |
| 101YP1600X Counselor, Pastoral (Licence: FL 15461) | |
| 106H00000X Marriage & Family Therapist (Licence: FL 15461) | |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2021-10-12 |