NPI | 1629572052 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 151672) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2023-12-22 |