NPI | 1851404206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 10727) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 003822-042155) |
Enumeration Date | 2006-08-17 |
Last Update Date | 2008-06-17 |