NPI | 1376100792 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.171401) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2019-05-21 |
Last Update Date | 2021-05-28 |