| NPI | 1760859938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171400000X Health & Wellness Coach (Licence: ID 11764917) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ID 11764917) |
| 101YP1600X Counselor, Pastoral (Licence: ID 11764917) | |
| 106H00000X Marriage & Family Therapist (Licence: CA 111448) | |
| 106H00000X Marriage & Family Therapist (Licence: CA LMFT111448) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2024-06-04 |