| NPI | 1922238856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2606471) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.2606471) |
| 101YM0800X Counselor, Mental Health (Licence: OH C.0700887) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2026-09-21 |