| NPI | 1043480478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF00000904) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00004849) |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2008-02-29 |