NPI | 1548569817 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E-0900072) |
Enumeration Date | 2011-03-25 |
Last Update Date | 2025-05-01 |