NPI | 1245664036 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 10663-R) |
106H00000X Marriage & Family Therapist (Licence: CA 70219) | |
Enumeration Date | 2013-08-28 |
Last Update Date | 2018-05-18 |