| NPI | 1841569837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 2989) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 11143) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2011-12-20 |