| NPI | 1528184496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0700113-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH s-0027461) |
| 1041C0700X Social Worker, Clinical (Licence: OH s-0027461) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-03-21 |