| NPI | 1831730043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61423679) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC61033536) |
| 225A00000X Music Therapist | |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2023-05-18 |