NPI | 1306039151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF00001387) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH0003749) |
Enumeration Date | 2007-08-24 |
Last Update Date | 2007-08-24 |