| NPI | 1659244275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2600670-TEMP) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YS0200X Counselor, School (Licence: OH C.2406386-TRNE) | |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2026-03-30 |