| NPI | 1902915861 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 5072) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 18744) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2024-05-22 |