| NPI | 1851677520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C3593) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: WA LH60676192) | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2023-10-25 |