NPI | 1922593243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 121981) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health (Licence: CA 110196) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-06-28 |
Last Update Date | 2022-12-19 |