| NPI | 1306219373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61399423) |
| Additional Taxonomies | 101Y00000X Counselor |
| 106H00000X Marriage & Family Therapist (Licence: WA MFTA.MG.61004781) | |
| Enumeration Date | 2015-11-12 |
| Last Update Date | 2023-03-31 |