| NPI | 1912972159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IN 35000835A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY KY-0108) |
| 101YM0800X Counselor, Mental Health (Licence: IN 35000835A) | |
| 106H00000X Marriage & Family Therapist (Licence: KY 105694) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2024-02-06 |