NPI | 1831267848 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 7932) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 15508) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2007-07-08 |