| NPI | 1093277600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT140646) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA AMFT137598) |
| 101YP2500X Counselor Professional (Licence: CA APCC3738) | |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT137598) | |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT97925) | |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2023-08-11 |