| NPI | 1568516870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E0008395) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YP2500X Counselor, Professional (Licence: OH E0008395) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2021-12-02 |