| NPI | 1740985183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2405427-TRNE) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 106S00000X Behavior Technician (Licence: OH BACB657330) | |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2024-03-04 |