| NPI | 1063970713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor |
| 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.173535) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2023-12-06 |