| NPI | 1831862705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT156953) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2025-09-03 |