| NPI | 1497998751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AZ LMFT-0374) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral (Licence: AZ 4573) |
| Enumeration Date | 2009-04-15 |
| Last Update Date | 2009-04-15 |