| NPI | 1467997544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2001588) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.1600656-TRNE) |
| 101YM0800X Counselor, Mental Health (Licence: OH C.1600656-TRNE) | |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2021-11-03 |