NPI | 1407462880 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 118889) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA AMFT118889) |
Enumeration Date | 2020-09-21 |
Last Update Date | 2021-03-11 |