| NPI | 1841980232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH S.2309106) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH S.2102223-TRNE) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-01-03 |