NPI | 1487346433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 13990) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 13990) |
Enumeration Date | 2023-05-25 |
Last Update Date | 2023-05-25 |