| NPI | 1093228223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2304824-SUPV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.165228) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 104100000X Social Worker (Licence: OH S1802042) | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2025-05-16 |