NPI | 1124628664 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 142993) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA R1406551020) |
171M00000X Case Manager/Care Coordinator | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-10-26 |
Last Update Date | 2023-11-27 |