| NPI | 1326362443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 126443) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2021-08-09 |