NPI | 1457199820 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 202000) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 78397) |
Enumeration Date | 2024-07-18 |
Last Update Date | 2024-07-18 |