NPI | 1528503646 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 136340) |
Additional Taxonomies | 101Y00000X Counselor |
171M00000X Case Manager/Care Coordinator | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-12-28 |
Last Update Date | 2022-12-13 |