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 |