NPI | 1447733134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 107685) |
Enumeration Date | 2018-09-10 |
Last Update Date | 2019-04-29 |