| NPI | 1861902850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60993754) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH60993754) |
| 171400000X Health & Wellness Coach | |
| 225600000X Dance Therapist | |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2024-09-24 |