NPI | 1679133193 |
---|---|
Other Name | JAIME HOSTICKA |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.1902038) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH C.1902038) |
Enumeration Date | 2019-06-17 |
Last Update Date | 2023-12-12 |