NPI | 1952534828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 091053 (LCDCII)) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 124036 (ICADC() |
Enumeration Date | 2009-08-26 |
Last Update Date | 2009-08-26 |