| NPI | 1891675161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C.2406527) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2406527) |
| Enumeration Date | 2025-09-05 |
| Last Update Date | 2025-09-05 |