| NPI | 1417471277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 108668) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-07-21 |