| NPI | 1134454671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH EOOO3798) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 0003798) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH E0003798) | |
| 101YP1600X Counselor Pastoral (Licence: OH E0003798) | |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2022-07-21 |