| NPI | 1033523105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH S1430054) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA140022PRE) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2014-06-17 |