| NPI | 1740423540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 3031) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: TX 3031) |
| 106H00000X Marriage & Family Therapist (Licence: TX 3031) | |
| 101Y00000X Counselor (Licence: TX 3031) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 4770) | |
| 101YM0800X Counselor Mental Health (Licence: TX 3031) | |
| 101YP1600X Counselor Pastoral (Licence: TX 3031) | |
| 101YP2500X Counselor Professional (Licence: TX 3031) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2022-02-01 |