| NPI | 1699245357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.1904067) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH S.1904067) |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2022-02-21 |