| NPI | 1528274693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: KY KY-0461) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |