| NPI | 1043877673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162958) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH LCDCIII.162413) |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2026-02-06 |