NPI | 1295273449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 100626) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PCCI 2117) |
Enumeration Date | 2017-02-08 |
Last Update Date | 2017-08-10 |