| NPI | 1538364740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP1600X Counselor, Pastoral | |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical (Licence: IN 34003367A) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2007-11-15 |