| NPI | 1861935926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.1600758) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: OH S.1600758) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |