| NPI | 1649740226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135187) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 191715) |
| 106H00000X Marriage & Family Therapist (Licence: CA AMFT110099) | |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2023-02-25 |