NPI | 1568681617 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH 0000464) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F029) |
Enumeration Date | 2007-04-25 |
Last Update Date | 2010-08-06 |