| NPI | 1801386263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2303826) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E.2303826) |
| 101YP2500X Counselor, Professional (Licence: OH E.2303826) | |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2024-10-26 |