| NPI | 1528512431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NE 1328) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: NE 1328) |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2016-08-09 |