NPI | 1285031799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF78672) |
Enumeration Date | 2014-11-26 |
Last Update Date | 2015-08-05 |