| NPI | 1063075851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH C.2002547) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH C.1801355-TRNE) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OH CDCA.168566) | |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2020-08-10 |