| NPI | 1861669590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 7565) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 106H00000X Marriage & Family Therapist (Licence: TX 3539) | |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2008-05-12 |