| NPI | 1952712945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: UT 14237444-3902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OK 1288) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2025-08-07 |