NPI | 1477647063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA RC00036020) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF00001059) |
Enumeration Date | 2006-10-03 |
Last Update Date | 2007-07-08 |