| NPI | 1265793764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60608531) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC60408047) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2024-11-14 |