| NPI | 1316331275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134528) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 7900) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-05-14 |