| NPI | 1992181440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 86775) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: CA 101145468) |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2024-03-08 |