| NPI | 1801019302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral (Licence: AR P9005009) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P9005009) |
| 106H00000X Marriage & Family Therapist (Licence: AR M9712037) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |