NPI | 1508919754 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA CG60138477) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60138477) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2013-06-18 |