NPI | 1497240501 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2411110) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162721) |
Enumeration Date | 2018-06-30 |
Last Update Date | 2024-10-28 |