| NPI | 1437242310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E-0004200) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.0004200-SUPV) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-03-13 |