NPI | 1831843085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT120534) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA APCC8181) |
Enumeration Date | 2022-02-07 |
Last Update Date | 2022-02-07 |