NPI | 1922741479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA AMFT123806) |
Additional Taxonomies | 101YP1600X Counselor, Pastoral |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2022-04-13 |
Last Update Date | 2022-04-13 |