NPI | 1952441966 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC51816) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 42865) |
Enumeration Date | 2007-02-07 |
Last Update Date | 2012-11-08 |