| NPI | 1093320178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.2102263) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1801078) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.161979) | |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2021-05-06 |