| NPI | 1659244275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: OH C.2406386-TRNE) |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2026-02-12 |