NPI | 1407036817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MG60192498) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA RC00058773) |
Enumeration Date | 2007-11-14 |
Last Update Date | 2013-01-08 |