NPI | 1750622627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 1551) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A10090) |
Enumeration Date | 2013-03-02 |
Last Update Date | 2015-12-22 |