NPI | 1821101551 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 714) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 96) |
101YP1600X Counselor, Pastoral (Licence: OK 00) | |
101YP2500X Counselor, Professional (Licence: OK 1424) | |
Enumeration Date | 2006-08-16 |
Last Update Date | 2025-09-11 |