| NPI | 1548656846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR A1501004) |
| 106H00000X Marriage & Family Therapist (Licence: AR F1501003) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2024-03-22 |