| NPI | 1568136992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2406190) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2304991-TRNE) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2024-06-20 |