| NPI | 1740587930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: LA 1334) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60340894) |
| 106H00000X Marriage & Family Therapist (Licence: WA LF60600292) | |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2018-03-28 |