| NPI | 1104214824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OH E. 1200549) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH E. 1200549) |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2024-03-13 |