| NPI | 1427461672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161650) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.141213) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCII.141213) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.130075) | |
| 104100000X Social Worker (Licence: OH S.1600613) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-05-23 |