NPI | 1578045654 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 139302) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106H00000X Marriage & Family Therapist (Licence: CA 117496) | |
Enumeration Date | 2018-09-05 |
Last Update Date | 2024-09-03 |