NPI | 1447386750 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LW00005343) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WA LW00005343) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2009-11-05 |