NPI | 1134741804 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2002927) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1901847-TRNE) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.173308) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2020-05-15 |
Last Update Date | 2020-10-15 |