| NPI | 1245842012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2404887) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2103754) |
| 101Y00000X Counselor (Licence: OH C2002556TRNE) | |
| Enumeration Date | 2020-08-21 |
| Last Update Date | 2025-05-05 |