NPI | 1629119946 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 49444) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSB94020289) |
106H00000X Marriage & Family Therapist (Licence: CA 47431) | |
Enumeration Date | 2007-02-09 |
Last Update Date | 2022-04-22 |