| 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 |