| NPI | 1922173491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AR A9810004) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A9810004) |
| 106H00000X Marriage & Family Therapist (Licence: AR A9810004) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2014-06-16 |