NPI | 1912450701 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E1600023) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E1600023) |
Enumeration Date | 2016-07-27 |
Last Update Date | 2024-04-30 |