| NPI | 1447617071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 141639) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 102133) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2023-10-04 |