| NPI | 1356529127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60572587) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 13-03-20) |
| 101YM0800X Counselor, Mental Health (Licence: OR C-3025) | |
| 101YP2500X Counselor, Professional (Licence: WA LH60572587) | |
| 101YP2500X Counselor, Professional (Licence: OR C 3025) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2022-07-12 |