NPI | 1205071438 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60746917) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00059911) |
Enumeration Date | 2008-12-02 |
Last Update Date | 2022-03-03 |