| NPI | 1659519908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0701159) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.0701159) |
| 101YP1600X Counselor, Pastoral (Licence: OH E.0701159) | |
| Enumeration Date | 2009-01-24 |
| Last Update Date | 2022-02-23 |