NPI | 1033468483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 112746) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2012-08-30 |
Last Update Date | 2021-12-30 |