| NPI | 1952762262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT124608) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106H00000X Marriage & Family Therapist (Licence: Trainee) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2023-10-30 |