NPI | 1346754504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AAMFT142360) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA AMFT142360) |
Enumeration Date | 2017-11-27 |
Last Update Date | 2023-11-07 |