| NPI | 1437880895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0800154) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker (Licence: OH I.0800154) | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2022-08-24 |