NPI | 1740794189 |
---|---|
Former Name | CHRIS TERRYNELSON |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TN 1423) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0002029) |
Enumeration Date | 2017-11-21 |
Last Update Date | 2023-12-22 |