| NPI | 1710135090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 50669) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA MFC50669) |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2014-06-27 |