| NPI | 1144571001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH 60110859) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60110859) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2021-12-17 |