| NPI | 1760859938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 111448) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 106H00000X Marriage & Family Therapist (Licence: OR LMFT-T3178) | |
| 106H00000X Marriage & Family Therapist (Licence: ID LMFT-3461971) | |
| 106H00000X Marriage & Family Therapist (Licence: MT BBH-LMFT-LIC-81657) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2025-10-22 |