| NPI | 1598014169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61003126) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC 51134) | |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2023-10-20 |