NPI | 1013159318 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA MFC46284) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106H00000X Marriage & Family Therapist (Licence: CA MFC 46284) | |
Enumeration Date | 2009-04-01 |
Last Update Date | 2018-05-17 |