NPI | 1598866733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 041051) |
Additional Taxonomies | 103T00000X Psychologist (Licence: OH 5977) |
106H00000X Marriage & Family Therapist (Licence: OH F052) | |
Enumeration Date | 2006-09-26 |
Last Update Date | 2007-07-08 |