| NPI | 1144187444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 161476) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 21914) |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2026-01-07 |
| Last Update Date | 2026-02-18 |