NPI | 1669227260 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 140185) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 14068) |
Enumeration Date | 2024-04-18 |
Last Update Date | 2024-04-18 |