| NPI | 1962271403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 204600) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 90221) |
| Enumeration Date | 2023-12-26 |
| Last Update Date | 2023-12-26 |