NPI | 1346449113 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC50682) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-07-12 |
Last Update Date | 2011-11-15 |