NPI | 1659076156 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT138719) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC13828) |
Enumeration Date | 2023-04-03 |
Last Update Date | 2023-06-12 |