NPI | 1023544566 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF94227) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-05-03 |
Last Update Date | 2018-04-16 |