| NPI | 1184196321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT140631) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 4120) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2023-09-08 |