NPI | 1609127554 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 85351) |
Enumeration Date | 2012-10-01 |
Last Update Date | 2025-06-04 |