NPI | 1740564996 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 98140) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-10-06 |
Last Update Date | 2017-02-28 |