NPI | 1417481839 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161432) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
104100000X Social Worker (Licence: OH S.1302069) | |
Enumeration Date | 2017-04-12 |
Last Update Date | 2021-02-19 |