| NPI | 1790736346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW00008270) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA LW00008270) |
| 106H00000X Marriage & Family Therapist (Licence: WA LW00008270) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-06-15 |