| NPI | 1073817110 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I 0009357)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 091094)  | 
| 1041C0700X Social Worker, Clinical (Licence: MI 6801083988)  | |
| Enumeration Date | 2011-01-04 | 
| Last Update Date | 2016-04-18 |