| NPI | 1427574748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: OH 161717) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: OH 161717) |
| 174H00000X Health Educator (Licence: OH 161717) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OH 161717) | |
| 101Y00000X Counselor (Licence: OH 161717) | |
| 261QP0904X Clinic/Center, Public Health, Federal (Licence: OH 161717) | |
| 225800000X Recreation Therapist (Licence: OH 161717) | |
| 405300000X Prevention Professional (Licence: OH 161717) | |
| 133NN1002X Nutritionist, Nutrition, Education (Licence: OH 161717) | |
| 1744R1102X Specialist, Research Study (Licence: OH 161717) | |
| 171400000X Health & Wellness Coach (Licence: OH 161717) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 161717) | |
| 171M00000X Case Manager/Care Coordinator (Licence: OH 161717) | |
| 208D00000X General Practice (Licence: OH 161717) | |
| 174400000X Specialist (Licence: OH 161717) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2025-10-06 |