| NPI | 1881194405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2506972) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162769) |
| 101YM0800X Counselor, Mental Health (Licence: OH C.2506972) | |
| 101Y00000X Counselor (Licence: OH C.2506972) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2025-12-07 |