| NPI | 1881208247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA AMFT148771) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2024-08-19 |