| NPI | 1710819776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2605050-TRNE) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2026-06-02 |
| Last Update Date | 2026-06-02 |