NPI | 1588042352 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1901129) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 150330) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 1500090) | |
Enumeration Date | 2015-05-13 |
Last Update Date | 2019-05-14 |