NPI | 1235333485 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 71929) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-06-12 |
Last Update Date | 2023-11-27 |