| NPI | 1497101984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 120467) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106E00000X Assistant Behavior Analyst | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2024-07-10 |