NPI | 1275797508 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OH 0001797) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 173323) | |
Enumeration Date | 2008-07-16 |
Last Update Date | 2024-08-15 |