| NPI | 1316127392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH C0600322) |
| Additional Taxonomies | 101YP1600X Counselor Pastoral (Licence: OH C0600322) |
| 101YP2500X Counselor Professional (Licence: OH C0600322) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |