NPI | 1043877673 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162413) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH LCDCIII.162413) |
Enumeration Date | 2019-05-20 |
Last Update Date | 2024-09-20 |