| NPI | 1689894404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 000675) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: NY 0000) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2023-01-31 |