NPI | 1922024074 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH i0005568) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I.0005568) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2007-12-19 |