| NPI | 1104334929 |
|---|---|
| Professional Name | LISA MCNICHOLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 169481) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OH 165655) |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2019-06-18 |