| NPI | 1356844849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162185) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2106970) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2024-03-07 |