| NPI | 1407454374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2303315-TRNE) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.177784) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2024-04-02 |