| NPI | 1336877323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2305423) |
| Additional Taxonomies | 225A00000X Music Therapist (Licence: OH 18191) |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2024-02-21 |