| NPI | 1508050055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0003203) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E . 0003203) |
| 106H00000X Marriage & Family Therapist (Licence: OH F . 0000072) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2016-11-09 |