| NPI | 1205714201 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT149190) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA APCC17607) |
| Enumeration Date | 2025-08-26 |
| Last Update Date | 2025-08-26 |