NPI | 1457485310 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC 46424) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-03-15 |
Last Update Date | 2014-07-28 |