| NPI | 1982186680 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2507550) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.2406132-TRNE) | 
| 101YM0800X Counselor, Mental Health | |
| 101YM0800X Counselor, Mental Health (Licence: C.2406132-TRNE) | |
| Enumeration Date | 2018-08-30 | 
| Last Update Date | 2025-09-29 |