| NPI | 1790988137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YS0200X Counselor, School (Licence: CA 2301033783) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC53922) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2026-04-17 |