NPI | 1194034959 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF 96499) |
Enumeration Date | 2010-09-28 |
Last Update Date | 2017-05-11 |