| NPI | 1528703873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61533595) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA MC61229255) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2024-12-09 |