NPI | 1124682794 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.168277) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2019-04-29 |
Last Update Date | 2019-04-29 |