| NPI | 1619734498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 33759) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 106H00000X Marriage & Family Therapist | |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-03-06 |