| NPI | 1780030726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 10371756-3902) |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2021-12-15 |