NPI | 1225787781 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.187231) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 187231) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 182925) | |
Enumeration Date | 2022-03-22 |
Last Update Date | 2024-03-12 |