NPI | 1689071300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 136101) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA AMFT108493) |
106H00000X Marriage & Family Therapist | |
101Y00000X Counselor | |
Enumeration Date | 2014-11-24 |
Last Update Date | 2024-02-18 |