| NPI | 1699824011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0001514) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS6667) |
| 106H00000X Marriage & Family Therapist (Licence: OH F.0000122) | |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC13799) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |