| NPI | 1255353793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT33242) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA LPCC1855) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2018-03-17 |