| NPI | 1457710923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.0900052-SUPV) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH LICDC.141038) |
| 101YP2500X Counselor Professional (Licence: OH OCPC.1045) | |
| 104100000X Social Worker (Licence: OH S.0031354) | |
| Enumeration Date | 2016-02-12 |
| Last Update Date | 2025-08-18 |