NPI | 1811145469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 202623) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
106H00000X Marriage & Family Therapist (Licence: CO 915) | |
Enumeration Date | 2008-09-08 |
Last Update Date | 2023-07-07 |