| NPI | 1689802431 |
|---|---|
| Former Name | CHRISTOPHER JAMES MOUTENOT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717001309) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 53644) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2017-04-17 |