| NPI | 1033820931 |
|---|---|
| Former Name | SIDNEY ELIZABETH NICOLE MEDAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.186173) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.182866) |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2024-07-15 |