NPI | 1750832457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2404313) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.2103178-TRNE) |
101YP2500X Counselor, Professional | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2016-10-18 |
Last Update Date | 2024-08-20 |