| NPI | 1316214448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60438322) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OR R1348) |
| 101YM0800X Counselor Mental Health (Licence: WA LH60439183) | |
| 101YP1600X Counselor Pastoral | |
| 106H00000X Marriage & Family Therapist (Licence: OR T0793) | |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2015-02-17 |