NPI | 1073689303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 82228) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-11-28 |
Last Update Date | 2021-12-08 |