NPI | 1376630665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 130357) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106H00000X Marriage & Family Therapist (Licence: CA imf62390) | |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2006-10-06 |
Last Update Date | 2022-01-04 |