| NPI | 1699121798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E1800940) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C1400625) |
| 101YM0800X Counselor, Mental Health (Licence: OH E1800940) | |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2019-12-23 |