NPI | 1558541367 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA RC00033455) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00033455) |
Enumeration Date | 2007-11-08 |
Last Update Date | 2018-11-26 |