| NPI | 1952266629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA 61645066) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 148044) |
| Enumeration Date | 2025-12-16 |
| Last Update Date | 2025-12-16 |