NPI | 1699412429 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.186162) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH QMHS) |
171M00000X Case Manager/Care Coordinator (Licence: OH 2022) | |
Enumeration Date | 2022-05-13 |
Last Update Date | 2024-01-09 |