| NPI | 1942745864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2309921) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OH S.1610519-TRNE) |
| 104100000X Social Worker (Licence: OH S.1901009-TRNE) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-01-01 |
| Last Update Date | 2024-07-10 |