NPI | 1073001905 |
---|---|
Former Name | KELLEY DENISE ROBINSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.188637) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2018-04-26 |
Last Update Date | 2024-10-15 |