NPI | 1033469721 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: OH F1300004-SUPV) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC.161006) |
101YP2500X Counselor, Professional (Licence: OK M0900021) | |
Enumeration Date | 2012-09-11 |
Last Update Date | 2016-04-22 |