| NPI | 1396019105 |
|---|---|
| Former Name | JORDAN LEONARD LIMBACH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2012-02-27 |
| Last Update Date | 2017-06-27 |