NPI | 1790791499 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 7398) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 4110) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2017-03-16 |