NPI | 1902023286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
104100000X Social Worker (Licence: CA MFT78459) | |
106H00000X Marriage & Family Therapist (Licence: CA IMFT78459) | |
Enumeration Date | 2007-04-19 |
Last Update Date | 2018-08-10 |