| NPI | 1467001636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.2200277) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IN 35002195A) |
| 106H00000X Marriage & Family Therapist (Licence: KY 273580) | |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2022-08-01 |