| NPI | 1013259969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH C1200155) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC081097) |
| 163W00000X Registered Nurse (Licence: OH RN240023) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2013-03-19 |