| NPI | 1487323820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 78681) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 78681) |
| 101YP1600X Counselor, Pastoral (Licence: TX 78681) | |
| 101YP2500X Counselor, Professional (Licence: TX 78681) | |
| 102L00000X Psychoanalyst (Licence: TX 78681) | |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-09 |