NPI | 1659875904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA AMFT112530) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2024-11-07 |