NPI | 1710423504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 92984) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA 92984) |
101YM0800X Counselor, Mental Health (Licence: CA 92984) | |
101YP1600X Counselor, Pastoral (Licence: CA 92984) | |
101YP2500X Counselor, Professional (Licence: CA 92984) | |
106S00000X Behavior Technician (Licence: CA 92984) | |
Enumeration Date | 2017-01-17 |
Last Update Date | 2017-01-17 |