NPI | 1487872024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 944016) |
Additional Taxonomies | 104100000X Social Worker (Licence: OH S0016465) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2007-07-08 |