| NPI | 1457410391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF00001669) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist (Licence: WA 00001669) | |
| 101YM0800X Counselor, Mental Health (Licence: WA 00001669) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO6066813) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2021-06-28 |