| NPI | 1487027330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 1202) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 4321) |
| Enumeration Date | 2015-10-31 |
| Last Update Date | 2015-10-31 |