NPI | 1982817086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 2236) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 426) |
Enumeration Date | 2007-05-07 |
Last Update Date | 2011-02-15 |