| 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 |