| NPI | 1043939796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.181721) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH QMHS) |
| 104100000X Social Worker (Licence: OH S.2202708-TRNE) | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OH QMHS) | |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-09-22 |