NPI | 1356852834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OH APS.000486) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.168817) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2017-10-24 |
Last Update Date | 2024-02-02 |