NPI | 1558401620 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 117293) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA IMF 59168) |
Enumeration Date | 2007-02-07 |
Last Update Date | 2020-01-15 |