| NPI | 1659502953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2023-10-19 |