| NPI | 1336522671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 1336522671) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management (Licence: OH 1336522671) | |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2023-02-16 |