| 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 |