| NPI | 1508226101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL PHM 1453) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: FL 1702-002) |
| 106H00000X Marriage & Family Therapist (Licence: PR 557) | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2019-04-02 |