NPI | 1467514596 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E1227 PCC-S) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 3877) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2007-07-08 |