NPI | 1699493916 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH QMHS) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH QMHS) |
171M00000X Case Manager/Care Coordinator (Licence: OH 2022) | |
Enumeration Date | 2022-08-22 |
Last Update Date | 2022-10-20 |