| NPI | 1326379637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF60173194) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA RC00046002) |
| 101Y00000X Counselor (Licence: WA CG60121736) | |
| 106H00000X Marriage & Family Therapist (Licence: TX 201619) | |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2020-07-16 |