| NPI | 1053809228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.2102121-SUPV) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IN 39005603A) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162142) | |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2025-09-10 |