| NPI | 1023397312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0007747) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 111075) |
| 101YP2500X Counselor, Professional (Licence: KY 0994) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2011-08-04 |