| NPI | 1457182842 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT156644) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2025-07-27 |