NPI | 1730256090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 822) |
101YP2500X Counselor, Professional (Licence: TX 822) | |
Enumeration Date | 2006-11-29 |
Last Update Date | 2025-09-11 |