NPI | 1932588076 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 81243) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2015-05-21 |
Last Update Date | 2020-08-06 |