| NPI | 1568505345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60977038) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFC 30864) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2020-02-05 |