| NPI | 1396914123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 140112) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 123244) |
| 106H00000X Marriage & Family Therapist (Licence: CA 123244) | |
| 225400000X Rehabilitation Practitioner (Licence: CA 95-2633765) | |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2023-08-07 |