NPI | 1811468622 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2203702) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 000878) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2018-12-06 |
Last Update Date | 2022-06-27 |