| NPI | 1407216476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E. 0002873) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.0019636) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2023-09-27 |