| NPI | 1104782184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WV 64469) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.191414) |
| Enumeration Date | 2026-01-02 |
| Last Update Date | 2026-01-06 |