NPI | 1780019703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MA 1776) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2013-09-10 |
Last Update Date | 2024-06-06 |