| NPI | 1548747157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2303272) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH C.2002528) |
| 104100000X Social Worker (Licence: OH E.2303272) | |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2024-04-01 |