| NPI | 1568879898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F.1700033-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1300264) |
| 106H00000X Marriage & Family Therapist (Licence: OH F1700033) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2023-01-05 |