NPI | 1144354309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC41226) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFC41226) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2023-06-10 |