NPI | 1104391275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 117305) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2018-10-04 |
Last Update Date | 2024-01-23 |