NPI | 1831693712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH I.1800766-SUPV) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I1800766) |
Enumeration Date | 2018-03-23 |
Last Update Date | 2023-02-20 |