| NPI | 1427091610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E757) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH E757) |
| 101YP2500X Counselor, Professional (Licence: OH E757) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-08 |