| NPI | 1346914207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 127111) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA AMFT127111) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2022-09-02 |