NPI | 1326772989 |
---|---|
Former Name | MISSY LEIGH WHITE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61328543) |
Additional Taxonomies | 221700000X Art Therapist (Licence: 20-217) |
Enumeration Date | 2022-07-11 |
Last Update Date | 2024-08-06 |