NPI | 1972487239 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 208.001372) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 157426) |
Enumeration Date | 2025-07-31 |
Last Update Date | 2025-08-23 |