NPI | 1356677199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 114877) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA IMF76150) |
Enumeration Date | 2009-10-29 |
Last Update Date | 2023-06-30 |