NPI | 1336751882 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 131575) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 11829) |
101YM0800X Counselor, Mental Health (Licence: CA 11829) | |
Enumeration Date | 2020-08-17 |
Last Update Date | 2024-03-28 |