| NPI | 1932691367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2203546-SUPV) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.162309) |
| 104100000X Social Worker (Licence: OH S.1903366) | |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2024-09-23 |