| 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 |