NPI | 1538374020 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH E-0003534) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E-0003534) |
101YP2500X Counselor, Professional (Licence: OH E-0003534) | |
106H00000X Marriage & Family Therapist (Licence: OH E-0003534) | |
Enumeration Date | 2007-05-10 |
Last Update Date | 2007-07-08 |