NPI | 1477726768 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 923193) |
Additional Taxonomies | 104100000X Social Worker (Licence: OH S-8555) |
Enumeration Date | 2008-04-08 |
Last Update Date | 2016-12-16 |