| NPI | 1306546700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00009194) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH00009194) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2023-03-06 |