| NPI | 1871837575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 91648) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA BCBA 1-12-10484) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2023-02-20 |