| NPI | 1811354038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2405157) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 150803) |
| 104100000X Social Worker (Licence: OH 2105942) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2024-08-26 |