| NPI | 1831256296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: OH 3230) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F.0000133) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2007-07-08 |