NPI | 1336835768 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 143230) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
172V00000X Community Health Worker | |
Enumeration Date | 2023-04-18 |
Last Update Date | 2024-01-31 |