NPI | 1861519621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 964432) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E-1932) |
106H00000X Marriage & Family Therapist (Licence: OH F-115) | |
Enumeration Date | 2007-03-24 |
Last Update Date | 2007-07-08 |