| NPI | 1669024865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2103431) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1901582-TRNE) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2022-10-26 |