NPI | 1306339288 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2208553) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.167018) |
Enumeration Date | 2018-06-14 |
Last Update Date | 2022-12-06 |