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 |