| NPI | 1740673144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP1600X Counselor Pastoral | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2024-07-15 |