| NPI | 1336891621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2305247) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH C.2203818-TRNE) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2023-07-10 |