NPI | 1225166051 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I9519) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I9519) |
Enumeration Date | 2007-03-01 |
Last Update Date | 2020-11-05 |