NPI | 1033739743 |
---|---|
Former Name | JONATHAN SKY ORNDOFF |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 43445) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 39812) |
101YP2500X Counselor, Professional (Licence: MT 43445) | |
Enumeration Date | 2020-04-22 |
Last Update Date | 2024-03-21 |