| NPI | 1972063063 |
|---|---|
| Former Name | MICHAEL STEVEN BUAKNECHT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA 60942160) |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2023-12-12 |