| NPI | 1033650361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA 60842867) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2018-05-04 |