NPI | 1710796586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT155693) |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
172V00000X Community Health Worker | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2025-01-06 |
Last Update Date | 2025-07-16 |