NPI | 1508676594 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 145668) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: 15987) |
Enumeration Date | 2025-01-10 |
Last Update Date | 2025-01-10 |