| NPI | 1386112209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA MC60897117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60897117) |
| 106H00000X Marriage & Family Therapist (Licence: WA MG60875274) | |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2020-11-10 |