| NPI | 1003326653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2405356) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 175T00000X Peer Specialist (Licence: OH APS.003697) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162366) | |
| 101YM0800X Counselor, Mental Health (Licence: OH QMHS) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2024-11-18 |