| NPI | 1437308517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61083733) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC60042044) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2024-12-11 |