| NPI | 1881115285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 11780) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 60738059) |
| 101Y00000X Counselor (Licence: OR R5432) | |
| 106H00000X Marriage & Family Therapist (Licence: WA 60738059) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2023-09-28 |