NPI | 1366687162 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT129228) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YM0800X Counselor, Mental Health (Licence: CA IMF58728) | |
106H00000X Marriage & Family Therapist (Licence: CA IMF 83871) | |
Enumeration Date | 2008-12-08 |
Last Update Date | 2023-06-15 |