| NPI | 1053078154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH 179285) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH 002412) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2022-02-16 |