| NPI | 1841410883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 828) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: DC PRC609) |
| 106H00000X Marriage & Family Therapist (Licence: TX 003041003122) | |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |