| NPI | 1023584315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA178605) |
| Additional Taxonomies | 251E00000X Home Health (Licence: OH 4238722) |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2021-11-22 |