| NPI | 1932744729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2103274) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C1902154) |
| 101Y00000X Counselor (Licence: OH APP000279573) | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2021-04-28 |