NPI | 1902137292 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT86372) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2010-01-26 |
Last Update Date | 2022-01-24 |