NPI | 1558772483 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 89000) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2014-05-14 |
Last Update Date | 2021-06-03 |