| NPI | 1205059433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E-0001669) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH E-0001669) |
| 106H00000X Marriage & Family Therapist (Licence: OH E-0001669) | |
| 101YP1600X Counselor, Pastoral (Licence: OH E-0001669) | |
| 101Y00000X Counselor (Licence: OH E-0001669) | |
| 101YM0800X Counselor, Mental Health (Licence: OH E-0001669) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2016-09-13 |