| NPI | 1225544521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT136879) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA AMFT93519) |
| 106H00000X Marriage & Family Therapist (Licence: CA 93519) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 93717) | |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2023-01-18 |