| NPI | 1447921770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.183275) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C2103434-TRNE) |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2024-06-26 |