NPI | 1578973384 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: KY 170794) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NM CMF0210941) |
Enumeration Date | 2014-05-01 |
Last Update Date | 2023-12-15 |