| NPI | 1023509460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: OH CDCA.173763) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.173763) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2025-03-14 |