| NPI | 1518523869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 225A00000X Music Therapist (Licence: OH 16099) | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2022-12-15 |