NPI | 1760717227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LA 767) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 2291) |
101YS0200X Counselor, School (Licence: LA 71721) | |
Enumeration Date | 2009-10-15 |
Last Update Date | 2009-10-15 |