NPI | 1851834089 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.172768) |
Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: OH 1828893) |
146N00000X Emergency Medical Technician, Basic (Licence: OH 156613) | |
Enumeration Date | 2016-11-19 |
Last Update Date | 2020-02-04 |