| 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 |