| NPI | 1184810244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT143167) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA AMFT112693) |
| 101Y00000X Counselor | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2023-11-29 |