NPI | 1972230993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCII.091009) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-08-02 |
Last Update Date | 2023-10-12 |