| NPI | 1851226708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 14243665-6009) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR R12146) |
| 101YM0800X Counselor, Mental Health (Licence: TX 100824) | |
| Enumeration Date | 2026-06-15 |
| Last Update Date | 2026-06-15 |