| NPI | 1023094067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH E0000363) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E0000363) |
| 101YM0800X Counselor Mental Health (Licence: OH E0000363) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2007-07-08 |