| NPI | 1144763368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 157133) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 129919) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-11-19 |
| Last Update Date | 2025-08-14 |