| NPI | 1801386263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.1801098) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: OH OH3127488) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2023-06-19 |