| NPI | 1154819431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH S1100316) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 081160) | |
| 101YM0800X Counselor, Mental Health (Licence: KY 257165) | |
| 101YM0800X Counselor, Mental Health | |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral (Licence: OH 000000) | |
| 101YP1600X Counselor, Pastoral | |
| 104100000X Social Worker (Licence: OH S1100316) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2022-09-09 |