| NPI | 1609883826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS3518) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA LCS3518) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC4315) | |
| 1041C0700X Social Worker Clinical (Licence: CA MFC4315) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2024-09-14 |