| NPI | 1033615828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT124318) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA AMFT105304) |
| 106H00000X Marriage & Family Therapist (Licence: CA 105304) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2021-02-16 |