| NPI | 1922238682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TN 839) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TN 244) |
| 101YP1600X Counselor Pastoral (Licence: TN 45) | |
| 101YP2500X Counselor Professional (Licence: TN 839) | |
| 106H00000X Marriage & Family Therapist (Licence: TN 337) | |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |