| NPI | 1972602977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP1600X Counselor Pastoral (Licence: OK 2268) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OK 975) |
| 106H00000X Marriage & Family Therapist (Licence: OK 104) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2007-07-08 |