NPI | 1962684563 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1505039) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 44465) |
101YP2500X Counselor, Professional (Licence: CA LPCC 388) | |
106H00000X Marriage & Family Therapist (Licence: AR M1501003) | |
106H00000X Marriage & Family Therapist (Licence: MO 2013015040) | |
Enumeration Date | 2007-12-05 |
Last Update Date | 2015-05-12 |