| NPI | 1629373170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA LMFT46192) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist (Licence: CA 46192) | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2025-01-30 |