| NPI | 1740993344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2406127) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2204525-TRNE) |
| Enumeration Date | 2022-12-29 |
| Last Update Date | 2024-06-12 |