NPI | 1306927868 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 991726) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E-0002607) |
Enumeration Date | 2006-10-18 |
Last Update Date | 2007-07-09 |