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Individual
MR. TIMOTHY JOHN ENEVOLDSEN
Active
Individual
MR. TIMOTHY JOHN ENEVOLDSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED., LPC, LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10727
TX
106H00000X
Marriage & Family Therapist
003822-042155
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095362201
—
TX
Enumeration date
08/17/2006
Last updated
06/17/2008
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