| NPI | 1568669216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WA RC00054687) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA RC00054687) |
| 101YM0800X Counselor, Mental Health (Licence: WA RC00054687) | |
| 101YP1600X Counselor, Pastoral (Licence: WA RC00054687) | |
| 101YP2500X Counselor, Professional (Licence: WA RC00054687) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2007-07-08 |