NPI | 1467766394 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 80870) |
Additional Taxonomies | 101Y00000X Counselor |
106H00000X Marriage & Family Therapist (Licence: CA IMF 68779) | |
Enumeration Date | 2010-08-03 |
Last Update Date | 2015-10-09 |