| NPI | 1811536998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 162427) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.170180) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 170180) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 173086) | |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2022-11-07 |