| NPI | 1669681029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NBCC77094) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: TX AAPC10958) |
| 106H00000X Marriage & Family Therapist (Licence: AAMFT101247) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-07-21 |