NPI | 1740527936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 84684) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 84684) |
106H00000X Marriage & Family Therapist (Licence: CA 104490) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-01-09 |
Last Update Date | 2018-02-21 |