| NPI | 1598698177 |
|---|---|
| Former Name | BAYLON HEIDER |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCAPre.196226) |
| Enumeration Date | 2026-06-04 |
| Last Update Date | 2026-06-04 |