| NPI | 1801057021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT42122) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LPCC1333) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC 42122) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2023-08-07 |