NPI | 1659530566 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 80524) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I.0001679) |
Enumeration Date | 2008-06-05 |
Last Update Date | 2008-06-05 |