NPI | 1437391844 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 124218) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 124218) |
Enumeration Date | 2009-03-31 |
Last Update Date | 2024-03-20 |