NPI | 1649934191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2305569) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2204381-TRNE) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2021-10-29 |
Last Update Date | 2024-09-20 |