NPI | 1326684655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT110276) |
Additional Taxonomies | 101YS0200X Counselor School (Licence: CA APCC6473) |
Enumeration Date | 2019-11-21 |
Last Update Date | 2019-12-03 |