| NPI | 1467991513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WA LH61118105) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101Y00000X Counselor (Licence: WA LH61118105) | |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2023-05-24 |