| NPI | 1144519158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA 101089) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 67657) |
| 101YM0800X Counselor, Mental Health (Licence: CA 67657) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 67657) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2018-10-30 |