| NPI | 1336732114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT131002) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CO MFT.0002002) |
| 106H00000X Marriage & Family Therapist (Licence: FL MT3805) | |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2026-04-23 |