| NPI | 1447744644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO 05991) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 05991) |
| 103TC1900X Psychologist, Counseling (Licence: CO 05991) | |
| 106H00000X Marriage & Family Therapist | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2024-11-11 |