| NPI | 1538699095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT124623) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT100583) | |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2022-12-30 |