NPI | 1538507694 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LMFT88817) |
106H00000X Marriage & Family Therapist (Licence: WA 60599604) | |
Enumeration Date | 2013-06-11 |
Last Update Date | 2022-07-21 |