| NPI | 1205333093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2102650-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH c.1901796) |
| 101YP2500X Counselor, Professional (Licence: OH E.2102650) | |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2023-07-27 |