| NPI | 1992824932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 1294) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 101YS0200X Counselor, School | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2009-12-10 |