| NPI | 1457673139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F0000120) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E0004292) |
| Enumeration Date | 2010-02-22 |
| Last Update Date | 2010-02-22 |