NPI | 1700491982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162183) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.175980) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2020-09-14 |
Last Update Date | 2021-07-28 |