| NPI | 1730989252 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 153755) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 18930) |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-03-27 |