| NPI | 1568567386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C2114) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral |
| 101YM0800X Counselor Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-06-06 |