| NPI | 1649681305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60530243) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA SC61009169) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2020-10-29 |