| NPI | 1083050207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT121957) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: AMFT99212) |
| 106H00000X Marriage & Family Therapist (Licence: CA 121957) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 99212) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2021-01-15 |