NPI | 1720159536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA RC00046996) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA LF00002545) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2007-07-08 |