| NPI | 1447445085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NY 001690) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 747) |
| 106H00000X Marriage & Family Therapist (Licence: CA 49947) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2021-03-21 |