| NPI | 1235738089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2106559) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.172819) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.176424) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2021-08-24 |