NPI | 1497925655 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60160364) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA RC00053248) |
Enumeration Date | 2008-03-04 |
Last Update Date | 2023-11-10 |