| NPI | 1740537919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001416) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0012613) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2018-06-20 |