NPI | 1073085353 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH QMHS) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CMS) |
Enumeration Date | 2018-12-26 |
Last Update Date | 2018-12-26 |