| NPI | 1366528515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH I 5448) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2019-11-06 |