NPI | 1386815256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00003052) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH00006263) |
Enumeration Date | 2008-03-18 |
Last Update Date | 2008-03-18 |