| NPI | 1487840807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF00001538) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH00004942) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2007-09-19 |