| NPI | 1023481306 |
|---|---|
| Former Name | TERESE MISENCIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 081201) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2017-01-12 |