| NPI | 1932655495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE TIMOTHY FANEUFF Clinical Therapist/Owner 419-324-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.1440117.supv) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |