| NPI | 1568674125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 2707) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 1999) |
| 101YP2500X Counselor, Professional (Licence: TX 11544) | |
| 106H00000X Marriage & Family Therapist (Licence: LA MFT 44) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2025-09-11 |