| NPI | 1619646486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT163613) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC22815) |
| 373H00000X Day Training/Habilitation Specialist | |
| 101Y00000X Counselor | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2026-06-10 |