NPI | 1194387316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: OH S.0029847) |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
Enumeration Date | 2019-07-08 |
Last Update Date | 2021-06-04 |