NPI | 1285878454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 46915) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA LMFT46915) |
103K00000X Behavior Analyst | |
Enumeration Date | 2009-05-01 |
Last Update Date | 2023-03-21 |