| NPI | 1780836577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 342) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KS 342) |
| 101YM0800X Counselor, Mental Health (Licence: KS 342) | |
| 101YS0200X Counselor, School (Licence: KS 342) | |
| 106H00000X Marriage & Family Therapist (Licence: KS 342) | |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2008-10-13 |