NPI | 1366038440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2005571) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.174832) |
Enumeration Date | 2020-12-14 |
Last Update Date | 2020-12-16 |