NPI | 1386736122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH E3412) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E3412) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2013-05-15 |