| NPI | 1770985152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0003239-SUPV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.965713) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 965713) | |
| 101YM0800X Counselor, Mental Health (Licence: OH E.0003239) | |
| 101YP2500X Counselor, Professional (Licence: OH E.0003239) | |
| 104100000X Social Worker (Licence: OH S.0021026) | |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2023-05-10 |