| NPI | 1801387840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2102323) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10000318) |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2025-03-30 |