| NPI | 1083445639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 88002895A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2405825-TRNE) |
| Enumeration Date | 2024-08-13 |
| Last Update Date | 2025-08-13 |