| NPI | 1962976837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH C.2204354) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1901502-TRNE) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2022-07-22 |