| NPI | 1215253109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E. 0500701 SUPV) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E. 0500701 SUPV) |
| 101YP1600X Counselor, Pastoral (Licence: OH E. 0500701 SUPV) | |
| 101YP2500X Counselor, Professional (Licence: OH E. 0500701 SUPV) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2010-07-29 |