| NPI | 1831638857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT130481) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA AMFT97865) |
| 106H00000X Marriage & Family Therapist (Licence: CA 130481) | |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2022-12-13 |