| NPI | 1073686986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E 0003283) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E 0003283) |
| 101YM0800X Counselor, Mental Health (Licence: OH E 0003283) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-09-19 |