NPI | 1770178030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.181994) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
101YM0800X Counselor, Mental Health (Licence: QMHS) | |
Enumeration Date | 2021-03-08 |
Last Update Date | 2023-09-28 |