| NPI | 1881320166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT147702) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC11708) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 94028471) | |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2024-08-30 |