| NPI | 1588031892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1901566) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: OH C.1700341) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2019-12-19 |