| NPI | 1568047736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT164016) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 101YP2500X Counselor, Professional (Licence: CA APCC22993) | |
| 171400000X Health & Wellness Coach (Licence: CA BF4B865954) | |
| Enumeration Date | 2021-03-10 |
| Last Update Date | 2026-06-23 |