| NPI | 1518100106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C0028343) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 011304) |
| 101YS0200X Counselor, School (Licence: OH OH1-40-3916) | |
| 104100000X Social Worker (Licence: OH S28343) | |
| Enumeration Date | 2009-04-12 |
| Last Update Date | 2009-04-12 |