| NPI | 1578801916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 201943) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 69270) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2024-04-29 |