| NPI | 1629566864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.1901205) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1500066) |
| 101YP2500X Counselor, Professional (Licence: OH E.1901205) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2023-04-18 |