| NPI | 1093579906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: OH 187920) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 187920) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2025-01-29 |