| NPI | 1467519777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR P9508020) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AR M9802013) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-06 |