| NPI | 1407399850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1901536-SUPV) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH M.1700036) |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2023-11-27 |