NPI | 1699004663 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 4445) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 4445) |
Enumeration Date | 2009-12-21 |
Last Update Date | 2024-08-31 |