NPI | 1295769982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF00001502) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00004315) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-26 |