NPI | 1811475965 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 137588) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2018-08-01 |
Last Update Date | 2023-02-03 |