| NPI | 1952881997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2506784) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH S.2107127) |
| 104100000X Social Worker (Licence: OH S.2107127) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2025-08-20 |