| NPI | 1124546866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH LE-00042117) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161479) |
| 101YP2500X Counselor, Professional (Licence: OH E.2102241) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH C.1500918) | |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2024-09-03 |