| NPI | 1801432398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT51778) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA LMFT51778) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2019-11-20 |