| NPI | 1598154676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA lcs9548) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA lcs9548) |
| 101YM0800X Counselor, Mental Health (Licence: CA lcs9548) | |
| 101YP1600X Counselor, Pastoral (Licence: CA lcs9548) | |
| 101YP2500X Counselor, Professional (Licence: CA lcs9548) | |
| 102L00000X Psychoanalyst (Licence: CA lcs9548) | |
| 103T00000X Psychologist (Licence: CA lcs9548) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA lcs9548) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: CA lcs9548) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA lcs9548) | |
| 103TC1900X Psychologist, Counseling (Licence: CA lcs9548) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA lcs9548) | |
| 103TE1100X Psychologist, Exercise & Sports (Licence: CA lcs9548) | |
| 103TF0000X Psychologist, Family (Licence: CA lcs9548) | |
| 106H00000X Marriage & Family Therapist (Licence: CA lcs9548) | |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |