NPI | 1841562949 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 405300000X Prevention Professional (Licence: OH OCPS4486) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII161791) |
Enumeration Date | 2012-02-03 |
Last Update Date | 2018-12-28 |