| NPI | 1801501978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175T00000X Peer Specialist (Licence: OH APS.003848) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 0007894) |
| 171M00000X Case Manager/Care Coordinator | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2023-01-23 |
| Last Update Date | 2026-06-18 |