| NPI | 1639557762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA imf 79043) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 79043 imf) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2018-03-17 |