| NPI | 1669456760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35001529A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 35001529A) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-08-21 |