| NPI | 1154088169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.2100219) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH C.2103145) |
| Enumeration Date | 2021-11-24 |
| Last Update Date | 2021-11-24 |