NPI | 1972602977 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OK 104) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: OK 2268) |
101YP2500X Counselor, Professional (Licence: OK 975) | |
Enumeration Date | 2006-09-22 |
Last Update Date | 2025-09-11 |