| NPI | 1225173453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA MFC41529) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP60304163) |
| 106H00000X Marriage & Family Therapist (Licence: WA LF 60304163) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2017-04-10 |