| NPI | 1679649867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 201-9-1-91-13) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ND 201-9-1-91-13) |
| 101YM0800X Counselor, Mental Health (Licence: ND 201-9-1-91-13) | |
| 106H00000X Marriage & Family Therapist (Licence: ID 2692) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2022-08-02 |