| NPI | 1104316330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.171907) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CMS) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH PRS.00701) | |
| 101YM0800X Counselor, Mental Health (Licence: OH QMHS) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2019-10-24 |