| NPI | 1902229974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: FL 1400011427) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: FL 101YP1600X) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2016-12-09 |