| NPI | 1851576532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC51258) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA RAS A0605161338) |
| 106H00000X Marriage & Family Therapist (Licence: CA IMF48761) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA A0605161338) | |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2012-07-24 |