NPI | 1043957301 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162608) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2405637-TRNE) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2022-05-18 |
Last Update Date | 2024-03-22 |