| NPI | 1326577297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT146729) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA AMFT112545) |
| 103K00000X Behavior Analyst | |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT112545) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2024-06-10 |