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 |