NPI | 1245893874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 121187) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2019-04-18 |
Last Update Date | 2022-05-06 |