| NPI | 1518270800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CA MFT30211) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 30211) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2023-03-24 |