| 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 | 2025-12-15 |