| NPI | 1386159499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 142910) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF112086) |
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2026-02-25 |