| NPI | 1437664604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO LPC.0014126) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0014126) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACB.0008270) | |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2025-09-04 |