NPI | 1922562446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 134755) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
106H00000X Marriage & Family Therapist (Licence: CA 115700) | |
Enumeration Date | 2019-01-29 |
Last Update Date | 2022-10-31 |