| NPI | 1306362330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161973) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.161573) |
| 171M00000X Case Manager/Care Coordinator (Licence: OH LICDC.161973) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2024-02-21 |