NPI | 1891132528 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.177188) |
Additional Taxonomies | 101Y00000X Counselor |
Enumeration Date | 2013-06-04 |
Last Update Date | 2021-09-16 |