| NPI | 1255985297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2203008) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1901842) |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2022-07-27 |