| NPI | 1366183030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH C.2305364-TRNE) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 184483) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2024-01-15 |