NPI | 1699248906 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA D399361) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
171M00000X Case Manager/Care Coordinator | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-01-09 |
Last Update Date | 2025-09-24 |