| NPI | 1205995289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.0001437) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH E1437) |
| 106H00000X Marriage & Family Therapist (Licence: OH F.0000005) | |
| 106H00000X Marriage & Family Therapist (Licence: OH F0000005) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2018-06-13 |