NPI | 1306206073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1100477) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.1100477) |
Enumeration Date | 2016-02-24 |
Last Update Date | 2023-12-29 |