NPI | 1649008798 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 148130) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 16723) |
Enumeration Date | 2024-07-22 |
Last Update Date | 2024-07-22 |