| NPI | 1386609279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 020703 MH30003562) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA 02073LH00004449) |
| 101YM0800X Counselor, Mental Health (Licence: WA 02073LH00004449) | |
| 101YP2500X Counselor, Professional (Licence: WA 020703 MH30003562) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2022-06-06 |