NPI | 1811391287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 87186) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2014-10-14 |
Last Update Date | 2021-06-08 |