NPI | 1063960250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OR T2213) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 77588) |
106H00000X Marriage & Family Therapist (Licence: CA 104774) | |
Enumeration Date | 2016-09-15 |
Last Update Date | 2024-01-01 |