| NPI | 1154832483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.1700025) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E1901016) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2020-02-25 |