| NPI | 1801278569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA MFT.LF.60560674) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MFT.LF.60560674) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2024-02-07 |