NPI | 1710503339 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.175898) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2020-06-19 |
Last Update Date | 2021-03-10 |