| NPI | 1487032207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT102727) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA LPCC5295) |
| 101YM0800X Counselor Mental Health (Licence: CO LPC.0015944) | |
| 106H00000X Marriage & Family Therapist | |
| 106H00000X Marriage & Family Therapist (Licence: CO MFT.0001733) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2024-12-04 |