| NPI | 1295919264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LMFT111373) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF - 77503) |
| 106H00000X Marriage & Family Therapist (Licence: CA Intern # - IMF55140) | |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF - 77503) | |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2020-03-11 |