| 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 |