| NPI | 1396882056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: AL LMFT29) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL LPC1366) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-04-26 |