NPI | 1104498922 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 150421) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2021-07-12 |
Last Update Date | 2024-10-17 |