NPI | 1821674003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.176149) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-03-19 |
Last Update Date | 2024-08-17 |