| NPI | 1811571128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2606208) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2204625) |
| 221700000X Art Therapist (Licence: OH ART.25000009) | |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2026-01-16 |