| NPI | 1467520221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH I-0005530) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH I-0005530) |
| 104100000X Social Worker (Licence: OH I-0005530) | |
| 1041C0700X Social Worker, Clinical (Licence: OH I-0005530) | |
| 106H00000X Marriage & Family Therapist (Licence: OH I-0005530) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2007-07-08 |