NPI | 1720278021 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MI 4101005363) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801014952) |
Enumeration Date | 2007-08-01 |
Last Update Date | 2007-08-01 |