| NPI | 1881314961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH 2309777) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH 2309777) |
| 104100000X Social Worker (Licence: OH 2309777) | |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2023-10-05 |