| NPI | 1659076156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT155595) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA APCC13828) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2025-12-05 |