| NPI | 1952141780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: VA 0717002163) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: UT 11301833-3902) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2026-04-22 |