| NPI | 1366086464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT156596) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: CA AMFT114070) | |
| 101YM0800X Counselor, Mental Health (Licence: CA 10007731) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 156596) | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2025-07-24 |