| NPI | 1023445574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2335) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH 161742) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 175463) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2022-07-25 |