NPI | 1356950430 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 136559) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2020-07-24 |
Last Update Date | 2024-03-31 |