| NPI | 1285110460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 104100000X Social Worker (Licence: OH S.2403902-TRNE) | |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2024-09-23 |