| NPI | 1609552306 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 146173) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 16296) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2024-04-20 |