| NPI | 1033980560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH 2506862) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 104100000X Social Worker (Licence: OH 2405501) | |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-02-22 |