NPI | 1467545665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AR M1010008) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 967) |
106H00000X Marriage & Family Therapist (Licence: MO 2012012968) | |
Enumeration Date | 2006-10-02 |
Last Update Date | 2024-02-07 |