| NPI | 1326702572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2411331) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2024-08-19 |