NPI | 1225783178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT136188) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2022-02-18 |
Last Update Date | 2023-05-01 |