| NPI | 1962918029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2303618) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161617) |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional (Licence: OH C.1801263) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2023-07-12 |