| NPI | 1598455586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134517) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 13517) |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2023-05-24 |