NPI | 1760847610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 121687) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2015-12-19 |
Last Update Date | 2023-10-24 |