NPI | 1568014181 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 132140) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2019-07-13 |
Last Update Date | 2023-03-17 |