| NPI | 1922493238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH61475043) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA CG60554426) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2024-04-17 |