| NPI | 1598095937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 3317) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 3317) |
| 101YP2500X Counselor, Professional (Licence: TX 3317) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 3317) | |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2010-01-07 |