| NPI | 1659865442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: OH S2102105) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2021-10-28 |