| NPI | 1851180301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT147160) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA APCC16744) |
| Enumeration Date | 2025-05-01 |
| Last Update Date | 2025-05-01 |