NPI | 1194908244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E0500400) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E0500400) |
Enumeration Date | 2007-12-12 |
Last Update Date | 2018-02-06 |