NPI | 1841664471 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60810335) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA SC60489162) |
Enumeration Date | 2015-11-19 |
Last Update Date | 2022-07-06 |