| NPI | 1467590430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 2070CP2414) |
| 1041C0700X Social Worker, Clinical (Licence: WA 20704LW4309) | |
| 106H00000X Marriage & Family Therapist (Licence: WA 20705LF930) | |
| 1041C0700X Social Worker, Clinical (Licence: WA 20704-LW4309) | |
| 106H00000X Marriage & Family Therapist (Licence: WA 20705-LF930) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 20706-CP2414) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2015-10-07 |