| NPI | 1598474116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2406017) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2204426-TRNE) |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2026-06-22 |