NPI | 1760629695 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60258116) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00044315) |
Enumeration Date | 2009-01-14 |
Last Update Date | 2023-06-20 |