NPI | 1497885776 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 8539) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 10995) |
Enumeration Date | 2007-03-06 |
Last Update Date | 2007-07-08 |