| NPI | 1184453466 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 141908) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 14733) |
| Enumeration Date | 2024-07-26 |
| Last Update Date | 2024-07-26 |