| NPI | 1619636842 |
|---|---|
| Other Name | DUSTY WHITEWATER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 135986) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Bii00310720) |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2024-04-29 |