| NPI | 1679726822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0157201) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NM 0157981) |
| Enumeration Date | 2008-11-01 |
| Last Update Date | 2021-09-24 |