NPI | 1972087526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WA LF61101396) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61028262) |
Enumeration Date | 2018-09-19 |
Last Update Date | 2024-01-04 |