NPI | 1851317895 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 8835) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 1884) |
103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 10968) | |
Enumeration Date | 2006-07-14 |
Last Update Date | 2025-09-03 |