NPI | 1659145191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 140697) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 15075) |
Enumeration Date | 2023-11-14 |
Last Update Date | 2024-03-28 |