| NPI | 1558805028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA IMF95530) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 112115) |
| 101YM0800X Counselor, Mental Health (Licence: CA IMF95530) | |
| Enumeration Date | 2016-12-18 |
| Last Update Date | 2025-09-24 |