| NPI | 1093339327 |
|---|---|
| Former Name | TERESA MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.173777) |
| Enumeration Date | 2020-06-02 |
| Last Update Date | 2020-06-02 |