| NPI | 1336848563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2405697) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2204522-trne) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-01-28 |