NPI | 1336347434 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00005378) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF00001428) |
Enumeration Date | 2007-07-10 |
Last Update Date | 2024-11-10 |