| NPI | 1790012995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PETER ORLOUSKY Member Manager 614-266-8278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E-0500159) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I-030656) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2009-11-09 |