| NPI | 1891127841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2303526) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH23765) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2025-01-30 |