| NPI | 1437450780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 66256) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: TX 66256) |
| 106H00000X Marriage & Family Therapist (Licence: TX 66256) | |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2013-10-25 |