| NPI | 1730747197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 9272) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1882) |
| 101YP1600X Counselor, Pastoral (Licence: TX 3472) | |
| 101YS0200X Counselor, School (Licence: TX 3472) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 1367) | |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2019-06-11 |