NPI | 1285959189 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 43050) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: CA sc 82671) |
101YP2500X Counselor, Professional (Licence: CA 878) | |
Enumeration Date | 2010-04-02 |
Last Update Date | 2014-03-06 |