| NPI | 1144307604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT29376) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LPCC1341) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2025-12-15 |