| NPI | 1659244275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2608008) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2600670-TEMP) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2026-05-12 |