NPI | 1740823905 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61067903) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA MG60607295) |
Enumeration Date | 2019-10-21 |
Last Update Date | 2021-08-17 |