| NPI | 1003183088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 132820) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF78099) |
| 101YM0800X Counselor, Mental Health (Licence: CA 116511) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 116511) | |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2023-05-19 |