| NPI | 1790575488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH QMHS) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH QMHS) | |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2025-05-07 |
| Last Update Date | 2025-05-19 |