| NPI | 1003329079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 161742) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2022-01-05 |