NPI | 1982125381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 131868) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH E.2102511) |
Enumeration Date | 2017-07-06 |
Last Update Date | 2022-07-05 |