| NPI | 1700990884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH 1041C0700X 5.0031124) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OH 1041C0700X 5.0031124) |
| 103TC1900X Psychologist, Counseling (Licence: OH 1041C0700X 5.0031124) | |
| 103T00000X Psychologist (Licence: OH 1041C0700X 5.0031124) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: OH 1041C0700X 5.0031124) | |
| 1041C0700X Social Worker, Clinical (Licence: OH 1041C0700X 5.0031124) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |