NPI | 1801963038 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH C0005518) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH C0005518) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2007-07-08 |