NPI | 1285058511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 27268) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT27268) |
106H00000X Marriage & Family Therapist (Licence: CA 27268) | |
Enumeration Date | 2014-02-06 |
Last Update Date | 2020-08-31 |