| NPI | 1124662994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT142110) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 116326) |
| 106H00000X Marriage & Family Therapist (Licence: CA 116326) | |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2024-02-29 |