| NPI | 1427650985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2103542) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2002753-TRNE) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2022-01-02 |