NPI | 1013403211 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH C.2204597) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.150229) |
Enumeration Date | 2018-07-11 |
Last Update Date | 2023-08-03 |