NPI | 1285725531 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 933746) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E-2412) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2022-07-21 |