| NPI | 1518400530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 127759) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 127759) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2025-03-28 |