NPI | 1639896160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA183079) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: QMHS) |
103K00000X Behavior Analyst | |
Enumeration Date | 2022-10-25 |
Last Update Date | 2023-01-17 |