| NPI | 1649934191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2305569) |
| 171M00000X Case Manager/Care Coordinator | |
| 101Y00000X Counselor (Licence: OH C.2204381-TRNE) | |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2025-11-18 |