NPI | 1710611280 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.187577) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2022-07-12 |
Last Update Date | 2024-05-09 |