| NPI | 1952940629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH C.1700731-TRNE) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1700731-TRNE) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2023-11-27 |