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 4982) |
101YM0800X Counselor, Mental Health (Licence: CA 16256) | |
101YP2500X Counselor, Professional | |
106H00000X Marriage & Family Therapist (Licence: CA 105789) | |
Enumeration Date | 2007-01-03 |
Last Update Date | 2025-05-06 |