| NPI | 1033742903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA186118) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2024-07-31 |