| NPI | 1104521558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA187534) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: OH APS.003604) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2024-10-09 |