NPI | 1255111860 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2405820-TRNE) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2023-10-02 |
Last Update Date | 2024-06-06 |