| NPI | 1578446233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| 106H00000X Marriage & Family Therapist | |
| 174H00000X Health Educator | |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-08-01 |