| NPI | 1598098006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC000524) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT000232) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2024-12-23 |