| NPI | 1538058433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 70277) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 70277) |
| 101Y00000X Counselor (Licence: CO 0021551) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 70277) | |
| 101YM0800X Counselor, Mental Health (Licence: CO 0021551) | |
| 101YP2500X Counselor, Professional (Licence: CO 0021551) | |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2025-07-02 |