NPI | 1407989700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT84796) |
Additional Taxonomies | 104100000X Social Worker |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-03-14 |
Last Update Date | 2015-07-08 |