| NPI | 1457408692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 146103) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 16256) |
| 101YM0800X Counselor, Mental Health (Licence: CA 4982) | |
| 106H00000X Marriage & Family Therapist | |
| 106H00000X Marriage & Family Therapist (Licence: CA 105789) | |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2024-05-09 |