| NPI | 1033076203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: CA 210136286) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 128044) |
| Enumeration Date | 2026-01-08 |
| Last Update Date | 2026-01-08 |